Çocuklarda Orta Kulak Patolojisini Belirlemede Geniş Bant Absorbans Ölçümünün Etkinliğinin Araştırılması

Yıl 2021, Cilt: 8 Sayı: 2, 385 - 402, 31.08.2021

Emrah Yıldız Hande Evin Eskicioğlu Aslı Çakır Selhan Gürkan Taner Kemal Erdağ Günay Kırkım

Öz

Amaç: Bu çalışmanın amacı çocuklarda iletim tipi işitme kaybı (İTİK)’in öngörülmesinde ve efüzyonlu otitis media (EOM)’nın belirlenmesinde geniş bant absorbans (GBA) ölçümünün etkinliğini değerlendirmektir.
Gereç ve Yöntem: GBA ve saf ses odyometri eşikleri normal orta kulak durumu ile 34 çocuktan (56 kulak) (yaş aralığı 3.58 ile 10.83 yıl, ortalama 7.01 yıl) ve İTİK’li 40 çocuktan (73 kulak) (yaş aralığı 3.42 ile 9.67 yıl, ortalama 6.04 yıl) ölçüldü. Katılımcılar aşağıdaki kriterlere dayalı olarak CHL grubuna dahil edildi: Hava-kemik aralığı (HKA) en az bir frekansta 20 dB ya da en az iki frekansta 15 dB, ve İTİK’in muhtemel nedeni olarak EOM ya da tuba Eustachii disfonksiyonu değerlendirildi. Bu iki ölçüm verisi GBA ve İTİK’in derecesi arasındaki ilişkiyi açıklamak amacıyla incelendi. Pearson korelasyonu ve regresyon analizi GBA’nın öngörü yeteneğini değerlendirmek için kullanıldı. ROC analizi duyarlılık ve özgüllük oranlarını belirlemek için uygulandı.
Bulgular: Absorbans İTİK grubunda tüm frekanslarda kontrol grubundan daha düşük gözlendi. Pearson korelasyon analizinde HKA ile ortam basıncındaki GBA arasında güçlü, anlamlı ve negatif korelasyon (R>0,69, p<0,000) bulundu. Regresyon analizinde HKA ile ortam basıncındaki GBA arasında, lineer modelde R-kare=0,779, kübik modelde R-kare=0,810, logaritmik modelde R-kare=0,783 bulundu.
Sonuç: ROC eğrisi altında kalan alan (AUC)’ye göre, ortam basıncındaki GBA, 226 Hz komplians ve timpanometrik genişliğe göre İTİK için daha iyi bir öngörü faktörü olarak düşünülebilir. GBA testi orta kulağın mekanik özelliklerini ölçmek için klinik bir tanı aracı olarak kullanılabilir ve aynı zamanda EOM hakkında daha ayrıntılı bilgi verebilir.

Anahtar Kelimeler

Geniş Band Timpanometri, Geniş Band Absorbans, Otitis Media, İletim Tipi İşitme Kaybı

Destekleyen Kurum

Dokuz Eylül Üniversitesi Bilimsel Araştırmalar Koordinasyon Birimi

Proje Numarası

2016.KB.SAG.006

Teşekkür

Çalışma Dokuz Eylül Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından 2016.KB.SAG.006 proje numarası ile desteklenmiştir.

Researching of the Efficiency of Wideband Absorbance Measurement in Determining Middle Ear Pathology in Children

Öz

Objective: The aim of the present study was to evaluate the efficiency of wideband absorbance (WBA) measurement in identifying Otitis media with effusion (OME) and in predicting conductive hearing loss (CHL) in children.
Methods: WBA and pure tone audiometry thresholds were measured from 34 children (56 ears) with normal middle ear status (age range 3.58 to 10.83 years, mean 7.01 years) and 40 children (73 ears) with CHL (age range 3.42 to 9.67 years, mean 6.04 years). Participants were included the CHL group based on the following criteria: Air-bone gap (ABG) 20 dB for at least one frequency or 15 dB for at least two frequencies, and otitis media or tuba Eustachii disfunction judged to be the possible cause of CHL. Two measurements data were analyzed to explain the relationship between WBA and the degree of CHL. Pearson correlation, and the regression analysis were used to evaluate the predicting ability of WBA. ROC analysis was performed to determine the sensitivity and the specificity rates.
Results: Absorbance at all frequencies in the CHL group was smaller than the control group. The pearson correlation analysis was found strong, significant and negative correlation (R>0,69, p<0,000) between ABG and WBA at ambient pressure. The regression analysis was found at linear model R-squared=0,779, at cubic model R-squared=0,810, at logarithmic model R-squared=0,783 between ABG and WBA at ambient pressure.
Conclusion: Based on the area under the ROC (AUC), WBA in ambient pressure was better predictors of CHL than 226 Hz compliance and tympanometric width. WBA testing may be used as a clinical diagnostic tool to measure the mechanic properties of the middle ear and also may give more detailed information about OME.

Anahtar Kelimeler

Wideband Tympanometry, Wideband Absorbance, Otitis Media, Conductive Hearing Loss

Proje Numarası

2016.KB.SAG.006

Kaynakça

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